肠淋巴液引流改善失血性休克大鼠液体复苏后的红细胞代谢  

Role of mesenteric lymph drainage improving the metabolism of red blood cell in hemorrhagic shock rats following fluid resuscitation

作　　者：韩瑞[1] 杜会博[1] 鲁蓓[1] 司永华[1] 张立民[1] 张玉平[1] 赵自刚[1] 牛春雨[1] 

机构地区：[1]河北北方学院微循环研究所,张家口075000

出　　处：《中国危重病急救医学》2012年第8期474-477,共4页Chinese Critical Care Medicine

基　　金：国家自然科学基金（30370561）;河北省自然科学基金（C2010001433）;河北省科技研究与发展计划项目（11276103D-84）;河北省张家口市科技研究与发展计划项目（0911021D-1,0911021D-2）;河北省高校百名优秀创新人才支持计划（CPRC047）

摘　　要：目的观察肠淋巴液引流对失血性休克大鼠液体复苏后红细胞代谢的作用。方法18只雄性Wistar大鼠，按随机数字表法均分为假手术组、休克组、休克＋引流组。复制失血性休克模型，维持低血压1．5h后，行液体复苏（全血量＋等量林格液）30min，复苏结束后继续观察3h。休克＋引流组维持低血压1h后引流肠淋巴液。在复苏后3h或相应时间点经腹主动脉取血，制备红细胞悬液，检测红细胞膜泵活性以及三磷酸腺苷（ATP）、乳酸（LA）水平；制备红细胞内液，检测2，3-二磷酸甘油酸（2，3-DPG）、Na＋、K＋浓度；制备血浆，检测Na＋、K＋、Cl-、总Ca浓度。结果与假手术组比较，休克组红细胞ATP（μmol／g）、Na＋-K＋-ATP酶（μmol．mg-1·h-1）、Ca2＋-ATP酶（μmol．mg-1·h-1）、血浆总Ca（mmo]／L）显著降低（ATP：6．698±0．938比10．670±1．466，Na＋-K＋-ATP酶：0．042±0．010比0．0664-0．019，Ca2＋-ATP酶：0．054±0．015比0．081±0．017，总Ca：2．27±0．18比2．66±0．21，P〈0．05或P〈0．01），红细胞LA（mmol／g）和血浆K＋（mmol／L）、Cl-（mmol／L）均显著升高（LA：3．472±0．853比1．743±0．395，K＋：5．83±0．34比5．23±0．37，Cl-：113．37±3．63比106．35±4．99，P〈0．05或P〈0．01），2，3-DPG（mmol／L）无显著差异（2．196±0．609比2．5904-0．574，P〉0．05）。与休克组比较，休克＋引流组红细胞2，3-DPG（4．459±0．900）、ATP（8．859±1．189）、Na＋-K＋-ATP酶（0．089±0．022）、Ca2＋-ATP酶（0．082±0．020）均显著升高．LA（2．060±0．810）显著下降（P〈0．05或P〈0．01），其他指标组间比较差异无统计学意义。结论休克肠淋巴液引流可改善失血性休克大鼠液体复苏后红细胞的代谢状况，保护红细胞结构与功能。Objective To observe the effects of mesenteric lymph drainage on the metabolism of red blood cell （RBC） in hemorrhagic shock （HS） rats following fluid resuscitation. Methods Eighteen male Wistar rats were randomly divided into sham group （n=6）, HS group （n=6）, HS ＋ drainage group （n=6）. After 1.5 hours of HS model prepared, the animals were given fluid resuscitation by lost blood plus equal volume of Ringer solution within 30 minutes in HS and HS ＋ drainage groups, and mesenteric lymph drainage was performed after 1 hour of hypotension in HS ＋ drainage group. At 3 hours after resuscitation or corresponding time, blood samples were obtained from abdominal aorta. Membrane suspensions of RBC prepared from part of whole blood samples were used to measure the activities of adenosine triphosphate ase （ATPase） and contents of ATP and lactic acid （LA）, the intracellular fluid of RBC prepared from part of whole blood samples was used to determine the concentration of 2,3-diphosphoglyceric acid （2,3-DPG）, Na＋ and K＋, plasma samples isolated from blood by centrifugation were used to determine the concentration of Na＋, K＋, Cl- and total Ca. Results Compared with sham group, the content of ATP （Ixmol/g）, activity of Na＋-K＋-ATPase （ μmol.mg-1·h-1） and Ca2＋-ATPase （μmol.mg-1·h-1） in RBC membrane and total Ca （mmol/L） in plasma were decreased markedly （ATP： 6.698 ±0.938 vs. 10.670 ± 1.466, Na＋-K＋-ATPase： 0.042 ±0.010 vs. 0.066 ＋ 0.019, Ca2＋-ATPase： 0.054 ± 0.015 vs. 0.081 ± 0.017, total Ca： 2.27 ± 0.18 vs. 2.66 ± 0.21, P〈0.05 or P〈 0.01 ） in HS group, and the content of LA （mmol/g） in RBC and K- （mmol/L）, Cl- （mmol/L） in plasma were increased observably in HS group （LA： 3.472 ± 0.853 vs. 1.743 ± 0.395, K＋： 5.83± 0.34 vs. 5.23 ± 0.37, Cl-： 113.37 ＋ 3.63 vs. 106.35 ± 4.99, P〈0.05 or P〈0.01 ）, there was no significant difference in term of the contents of 2,3-DPG （mmol/L： 2.196 ± 0.609 vs. 2

关 键 词：肠淋巴液 引流术 失血性休克 液体复苏 红细胞 代谢 

分 类 号：R459.6[医药卫生—治疗学]